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2019 ASCO-SITC Symposium: Predicting Outcomes With Immunotherapy for Melanoma

By: Sarah Campen, PharmD
Posted: Tuesday, March 12, 2019

A series of prognostic models developed by researchers at the Massachusetts General Hospital may help predict outcomes of anti–PD-1 monotherapy in patients with advanced melanoma. Based on clinical characteristics and easily accessible routinely tested biomarkers, the prognostic scoring system may allow clinicians to “optimally select patients who are most and least likely to benefit” from this immunotherapy, stated Xue Bai, MD, of Massachusetts General Hospital, Boston, and colleagues. Their findings were presented at the 2019 American Society of Clinical Oncology–Society for Immunotherapy of Cancer (ASCO-SITC) Clinical Immuno-Oncology Symposium in San Francisco (Abstract 133). 

The investigators performed a retrospective analysis of 141 patients with advanced melanoma treated with anti–PD-1 monotherapy at Massachusetts General Hospital to create the scoring models. Several independent prognostic variables significantly favored longer progression-free survival, including cutaneous subtype and low baseline lactate acid dehydrogenase (LDH) level; low early-on-treatment–derived neutrophil-to-lymphocyte ratio; and high early-on-treatment albumin, basophil, and red blood cell counts. Prognostic variables in favor of longer overall survival included BRAF V600 mutation; low baseline LDH level, neutrophil-to-lymphocyte ratio, and early-on-treatment LDH; and high early-on-treatment total protein, basophil, and lymphocyte counts.

Dr. Bai and colleagues developed the prognostic scoring models, with a scale from 0 to 6, using these independent prognostic factors. In patients with progression-free survival scores of ≤ 2, 3, 4, 5, and 6, the rates without disease progression at 6 months were 0%, 9.4%, 31.0%, 67.3%, and 80.0%, respectively. For patients with overall survival scores of ≤ 2, 3, 4, 5, and 6, the survival rates at 12 months were 25.0%, 68.4%, 79.3%, 97.1%, and 100%, respectively.

Disclosure: The study authors’ disclosure information may be found at coi.asco.org.



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